International Journal of Advanced Research in Medicine

Journal Information
ISSN / EISSN : 2706-9567 / 2706-9575
Published by: AkiNik Publications (10.22271)
Total articles ≅ 338
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Hemant Mehta, Abhay Bhave, Jhoomar Makhija, Wasiyeeullah Shaikh, Bhagyashree Gorakh, Pallavi Tanpure, Nawal Kaz
International Journal of Advanced Research in Medicine, Volume 4, pp 103-106; https://doi.org/10.22271/27069567.2022.v4.i1b.345

Abstract:
Acute kidney injury presenting without obvious cause is a diagnostic dilemma. One condition to be considered is monoclonal gammopathy. A case of light chain deposition disease was detected as a cause, involving kidney and extra renal site. It is a part of monoclonal immunoglobulin deposition disease, and may or may not be related to multiple myeloma. Delayed diagnosis can lead to end stage kidney disease, requiring long term dialysis, with its vascular access problems, preventing the treatment by autologous stem cell transplant. The case is presented with review of literature.
Gayathri Acharya, Umesh Mohan Cs, Pranamya Jain
International Journal of Advanced Research in Medicine, Volume 4, pp 107-113; https://doi.org/10.22271/27069567.2022.v4.i1b.346

Abstract:
Scientists currently debate the future of nanotechnology may be able to create many new materials and devices with vast range of application such as in nano medicine. The potency of homoeopathic medications increases with potentization. The thrown challenge to scientific community at large with the good clinical results. As we found that the homoeopathic medicine Baptisia tinctoria and Belladonna had shown good results on fever. According to calculation using avogadro's limit, preparations above 12C dilutions should have no source materials present. Even though 1M, 30C were above the Avogadro’s limit they showed the presence of photochemical like glycosides, proteins and also showed good antimicrobial activity.
A Raghuram Bhargavi, Nagjere Shirisha, Veera Mohan Kumar, M Gopinath
International Journal of Advanced Research in Medicine, Volume 4, pp 117-119; https://doi.org/10.22271/27069567.2022.v4.i1b.348

Abstract:
Background: Urinary tract infection is one of the most frequent bacterial infections in the elderly population occurring both in the community and in the long term care settings. Asymptomatic bacteriuria is common among the same elderly population which should be differentiated from obvious urinary tract infections. Objectives: To identify the prevalence of asymptomatic bacteriuria (ASB) in elderly females from rural background and to examine associated risk factors Methods: In this prospective observational cross sectional study a total of 100 elderly female patients aged 60 years and above from rural background in whom routine urine examination revealed bacteria or pus cells without symptoms of urinary tract infection are studied.Results: Out of the 100 elderly female patients, 68 patients were found to have Asymptomatic Bacteriuria (ASB). Risk factors associated with asymptomatic bacteriuria are Diabetes mellitus, catheterisation, urinary incontinence and structural urinary tract abnormalities. E.coli was the most common organism isolated in asymptomatic bacteriuria patients.Conclusion: The prevalence of Asymptomatic bacteriuria was significantly high in rural elderly female patients and it should be correlated with the clinical features of CUE findings of pus cells or bacteriuria and also the risk factors associated with UTI, so that patient with Asymptomatic bacteriuria are segregated from patients with UTI who require antimicrobial therapy.
Dilshad Kauser
International Journal of Advanced Research in Medicine, Volume 4, pp 31-43; https://doi.org/10.22271/27069567.2022.v4.i1a.320

Abstract:
A 71-year-old male patient with cerebral Mucor mycosis was referred from a local COVID-19 treatment facility. Written informed consent was obtained from the patient for publication of the patients’ details and images. The patient had an awake craniotomy and had a gross total tumour excision. There was no need to switch to general anaesthesia, The operation lasted four hours and thirty minutes. Throughout the awake craniotomy, the patient was haemodynamically stable, calm, cooperative, and comfortable. Amphotericin infusion administered at the end of the surgery, and Dexmedetomidine infusion administered after skin closure and the patient was completely awake and responsive when he was transferred out of the operating room and the patient's neurological condition improved post-surgery. On post-operative day 5, a repeat COVID-19 test came out negative, and the patient was discharged. A thirty-day post-operative assessment confirmed the patient's increasing motor gain. Although maintaining analgesia and hemodynamic stability with the patient awake was challenging, a target-controlled propofol infusion gave the required level of awareness, fentanyl titrated analgesia and sedation without drug accumulation, and bupivacaine blockade provided appropriate analgesia. We came to the conclusion that our patient's anaesthetic method was effective and It is possible to do an awake craniotomy in a COVID-19 positive patient with the requisite PPEs.
Mandeep Kalsi, Parisa Farzanehfar, Rachael Coutts, Alison Giles, Susie Sangas
International Journal of Advanced Research in Medicine, Volume 4, pp 95-97; https://doi.org/10.22271/27069567.2022.v4.i1b.343

Abstract:
International Medical Graduates (IMGs) are faced with unique educational needs and challenges during transition to Australian healthcare setting. Although IMGs’ issues have been well identified in the literature, limited interventions were done to overcome the gaps. The aim of this study is to provide a platform of learning and to improve confidence in IMGs to work more competently and independently in Australian healthcare system. At Northern Health we applied the community of practice (CoP) framework to establish an education program for IMGs and Clinical Observers. Our findings show that ‘IMG Education Program’ is highly regarded by IMGs and clinical observers; 87% are satisfied with IMG education sessions and 93.5% regard digital communication platforms highly. This program provides the opportunity for IMG JMOs and Observers to engage with their community; share information, improve skills, build relationships and develop a repertoire of shared resources to enable a smoother transition to the Australian medical workforce.
Reshma P, Robin Manidas, Lakshmi Ramakirshnan
International Journal of Advanced Research in Medicine, Volume 4, pp 172-175; https://doi.org/10.22271/27069567.2022.v4.i1c.364

Abstract:
Introduction: SARS-CoV-2 infection often experience hypoxic respiratory failure and invasive mechanical ventilation requirement. As pandemic progresses, ICU beds and mechanical ventilators may become rate-limiting factor. Prone positioning in conscious patients may improve oxygenation avoiding mechanical ventilation. We conducted retrospective study regarding proning in nonintubated patients in COVID ICU.Objective: Primary objective: change in SpO2 and PaO2 in ABG in non intubated COVID-19 patients who underwent awake prone positioning (PP). Secondary objective: PaO2 and PaCO2 variation before and during PP or after resupination. Intubation incidence within 2 weeks of first PP trial.Methodology: This retrospective study was conducted in SMCH from June – July 2020 among awake, nonintubated COVID 19 patients in ICU.Inclusion criteria: Patients with SpO2 >93 % with oxygen by face mask or nasal canula @ 2-10L/min.Exclusion criteria: Altered mental status and impaired consciousness. We collected demographics, vitals, and position data.Prone positioning: Placing patient on his or her stomach with head on side. Patient advised to remain in prone position as long as he can tolerate to maximum of 12hrs/day. Parameters such as HR, BP, SpO2 and PaO2 were measured before and during PP or after resupination at 30mins interval.Result: Our retrospective study, suggest that in COVID-19 patients with mild to moderate acute hypoxic respiratory failure, conscious proning can lead to oxygenation improvement, less invasive ventilation requirement, shorter hospital stay length and better overall outcomes.
Akash Thm, Madhu S, Sharvani R Setty, Vagesh Kumar Sr
International Journal of Advanced Research in Medicine, Volume 4, pp 24-30; https://doi.org/10.22271/27069567.2022.v4.i1a.317

Abstract:
Introduction: Diabetes Mellitus is independent risk factor for pulmonary infections manifesting with serious clinical features, frequent complications, increased morbidity & mortality.Objectives: Determine whether the clinical, radiological findings & causative organisms of pulmonary infections are modified in Diabetes mellitus.Methods: Prospective analytical case control study conducted from June 2016 - june2018 involving 150 Type 2 diabetes & 80 non-diabetic controls selected on basis of simple random sampling. RBS, Chest X-ray, sputum AFB, culture sensitivity were done.Results: Patients in diabetic group had longer duration-of-hospital stay, symptoms like cough, sputum production, breathlessness & fever.Patients in diabetic group had higher incidence of lower zone opacity, cavities & pleural effusion compared to non-diabetics, sputum showed higher positivity rate for gram-negative bacilli & fungal elements, higher incidence of pulmonary tuberculosis & culture showed higher rates of staph-aureus, candida species, klebsiella & pseudomonas which were sensitive to higher antibiotics like imipenem. Diabetic group had more complications like prolonged duration of hospital stay, pleural effusion, respiratory failure, anemia & mortality compared to non-diabetic group.Conclusion: Diabetics had significantly longer duration of symptoms like cough, sputum production, breathlessness & fever compared to non-diabetics. Tachypnea, cyanosis were more in diabetics. Diabetic patients had higher-involvement of lower zones, cavity & pleural effusion on chest x-ray. Gram stain & KOH showed higher incidence of gram negative bacilli and fungal elements. Pulmonary tuberculosis presenting as pneumonia & cavitatory lesions were significantly higher among diabetics compared to non-diabetics, Diabetics had significantly higher incidence of pulmonary infections due to staph. Aureus, klebsiella and pseudomonas, candida species. Diabetic patients had significantly prolonged duration of hospital stay, pleural effusion, sepsis, respiratory failure, anemia & mortality when compared to non-diabetics
M Sundareshwaran, Saritha K Narayanan, M Ramakrishna Rao
International Journal of Advanced Research in Medicine, Volume 4, pp 08-13; https://doi.org/10.22271/27069567.2022.v4.i1a.312

Abstract:
Background: India with population of around 1.38 billion harbours nearly 200 million1 hypertension patients. Hypertension is an important non-communicable disease with multifactorial biological aspects for its pathogenesis. Many recent analytical studies supported the evidence of low serum vitamin D level in pathogenesis of hypertension. Our objective was to estimate serum vitamin D level in patients with hypertension and hypertension related complications.Aims & Objectives: 1. To estimate serum Vitamin D level in Essential Hypertension and Hypertension related complications. 2. To establish the relationship between serum Vitamin D level and Hypertension and hypertension related complications.Materials & Methods:Design: Hospital based Observational studyPlace of Study: Department of General MedicineStudy Population: Cases attending RMMCH OPD during the study period will be screened for hypertension and hypertension related complications.Sample Size: 100Results: It has been observed that in this study serum vitamin D level is low in hypertension patients and also, the lower level correlated with hypertensive complications like retinopathy, nephropathy and cardiac complications.Conclusion: The study results reveals that low serum vitamin D level is present in significant number of study populations. Also the low serum vitamin D level correlated with hypertension related complications.
Samer Talib, Nazar Raoof
International Journal of Advanced Research in Medicine, Volume 4, pp 225-228; https://doi.org/10.22271/27069567.2022.v4.i1d.383

Abstract:
The first case of CD was described in 1950. Castleman disease (CD) is a rare group of heterogeneous lymphoproliferative disorders that share histopathological features related to the increased release of cytokines, particularly interleukin 6 (IL-6). CD has many etiologies, presentations, treatments, and outcomes. CD can be classified as unicentric Castleman disease (UCD) or Multicentric Castleman disease (MCD). UCD affects a single group of lymph nodes, whereas MCD affects multiple groups of lymph nodes. There are no known risk factors for UCD. MCD can either be idiopathic or associated with an immunocompromised state which may lead to the proliferation of B-lymphocytes as well as plasma cells in lymphoid organs in different body regions. Moreover, MCD has a preference for male over female patients. The average age for diagnosing MCD is the sixth decade. Contrarily, UCD has no gender preference and it is typically diagnosed in the fourth decade. UCD can present as asymptomatic lymphadenopathy or as a progressive enlargement of the lymph nodes. UCD is incidentally diagnosed on imaging of the chest or abdomen. MCD may present with lymphadenopathy, cytopenia or constitutional symptoms. The treatment options for UCD and MCD may include monoclonal antibodies, cytotoxic therapy, chemotherapy, radiotherapy or surgery.
Leelavathi Bikumalla
International Journal of Advanced Research in Medicine, Volume 4, pp 186-189; https://doi.org/10.22271/27069567.2022.v4.i1c.371

Abstract:
Background of this study: Shivering is the most general adverse effect occurs after the administration of anaesthesia with several aetiologies. In order to control the shivering, drug such as tramadol is broadly required. Nausea as well as vomiting is majorly caused by the drug tramadol. Therefore, there is a search for the efficient drug that lacking of adverse effects. Aim of the study: The goal of this study was to evaluate the efficiency of tramadol as well as dexmedetomidine in the medication of post spinal anesthesia shivering and also to examine their associated adverse effects. Materials and Methods: 60 number of patients having shivering after the administration of spinal anaesthesia were arbitrarily separated to two groups include Group D and Group T, each injected with 0.5 µg/kg of dexmedetomidine and 0.5 m/g/kg of tramadol along with 100 ml of normal saline respectively. The rate of response, onset of shivering, time taken for cessation of shivering, percentage of recurrence as well as associated effects was observed. All the data were assessed by means of independent t test analysis as well as chi square assessment to find out the significant value. Results: Both the drugs such as tramadol and dexmedetomidine are efficiently managed the shivering effectively as well as both take approximately the similar time for its deactivation. This study found that the associated unfavourable effects include vomiting and nausea is higher in Group T, so the patients in Group T need proper medication. The occurrence of recurrence of shivering was elevated in Group T. Conclusion: Dexmedetomidine provides good outcomes as compared to tramadol with less associated effects.
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